These minutes are in
compliance with Senate and House Rules.Only text enclosed in quotation marks reports a speaker’s exact
words.For complete contents,
please refer to the tapes.

TAPE/#

Speaker

Comments

TAPE 28, A

005

Co-Chair
Winters

Calls
the committee to order at 3:15 p.m. Opens a public hearing on HB 3624 A.

HB 3624 A – PUBLIC HEARING

010

Jim
Russell

Director,
Mid-Valley Behavioral Care Network. Speaks on HB 3624 A on behalf of the
Association of Oregon Community Mental Health Programs and mental health
organizations. Discusses the purpose of HB 3624 A.

025

Sen.
Carter

Asks
for clarification of original statement in terms of relationship to
hospitalization. Presents –A16 amendments dated 6/5/03 and accompanying memorandum
(EXHIBIT A & B).

045

Russell

Clarifies
bill proposes all psychiatric medications to fully capitated health plans
except for anti-psychotics. Discusses why anti psychotics is not part of the
program. Adds health plans will be managing the medications but mental health
organizations will continue to have financial risk of hospital care paying
costs. Refers to page 2, paragraph 2 of submitted testimony (EXHIBIT C).

075

Russell

Discusses
pilot projects. Comments last year $12 million a month was spent on medications.
States the need to introduce management strategies to save money. Expresses the
need to improve the quality of administration.

080

Sen.
Carter

Asks
what entity is responsible for the management of different drugs a patient may
have.

085

Russell

States
the psychotic drugs are carved out of the Oregon Health Plan (OHP) and paid
fee for service. Adds the State has no one to manage them currently.

087

Sen.
Carter

Asks
for clarification.

090

Russell

States
the anti-psychotic medication in fee for service, but proposes that the fully
capitated health plans cover the rest of the psychiatric medications.

110

Co-Chair
Winters

Asks
if it is true that without having the other 60% poses a financial risk.

115

Russell

Responds
yes. States medications would be managed by fully capitated health plans but
hospital care would still be provided by mental health organizations.

120

Sen.
Carter

Asks
in order have the opportunities to be fully responsible, the piece needs to
be carved out, and then you have responsibility and accountability.

125

Russell

Recommends
in sections 10 and 11 to exclude all the mental health drugs. Understands Legislative
Counsel feels it would be appropriate to place it somewhere else in the bill.
Expresses interest in returning when the amendments are drafted.

140

Paul
Cosgrove

Long
Term Care Pharmacy Association. Explains they provide prescription drugs to
many facilities. Provides examples. Testifies in support of the A-11 amendments
(EXHIBIT D). Mentions the amendments
address concerns the committee had. Refers to section 10 of the bill and the A-11
amendments. States drugs to the institutional clients in these facilities are
fee for service.

165

Cosgrove

States
the bill imposes a pharmacy benefit manager. Clarifies section 10 and section
13. Discusses differences in how long term care or institutional pharmacies
operate compared to retail pharmacy. States by law required to have daily
deliveries with seven day a week coverage. Claims pharmacy benefits are
managed in conjunction with facilities. Notes no other states have tried to
impose a pharmacy benefit manager on this aspect. Adds they work with
facilities to make sure drug utilization is both effective and safe.

207

Sen.
Carter

Asks
if it is a duplication of effort. Wonders why they would add another layer on
top of management that already exists.

210

Cosgrove

Responds
and agrees with Sen. Carter.

215

Jane
Myers

Director
of Government Affairs, Oregon Dental Association. Submits written testimony (EXHIBIT E). States major concern is
a need to keep the fee for service system available. States the bills
direction is to move more people into managed care.

275

Paul
Nielsen

Representing
Well Partner Incorporated. States Well-Partner is a mail order pharmacy,
owned and operated by Oregonians that ships products out of Portland. Defines
mail-order pharmacy.

320

Nielsen

Claims
reasons for amendment was the mail order concept was left out of HB 3624 A.
Mentions concerns. Claims Well-Partner Incorporated is the winner of a
contract for fee for service population. States they do not have the labor consulting
issues or the burden of retail.

380

Nielsen

Points
out the amendment do not require mail order to be used. Claims it is
estimated for every 1% increase in the Oregon Health Plan population that use
mail order , there will be an
estimated $1.2 million savings per year to the state.

TAPE 29, A

005

Nielsen

Claims
not all fully capitated health plans have made a decision. Notes the use of
mail order can cut costs, create efficiencies
and provide service.

025

Sen.
Minnis

States
we need a new amendment addressing section 6. Asks if we are going to have it
today.

030

Co-Chair
Winters

States
Legislative Counsel is working on it. States amendments will not be reviewed
today.

055

Nielsen

States
it does not force them to use mail order, but if the committee agrees to put
a sunset on this in 2008, it would tie their hands.

065

Sen.
Minnis

Asks
whether there would be a constitutional contract clause that is pre existing
based upon the set of assumptions.

Responds
yes they are located in Tualatin.. Suggests adding to exempt persons residing
in long-term care facilities, foster homes, etc to the -A16 amendments. Claims
placing them in a managed care mandate would be a duplication of effort.

160

Holt

Refers
to page 7, section 13. Explains the reason for changing the language from
manager to administrator. Feels it is more appropriate.

180

Rep.
Westlund

Asks
if leaving the language as it currently is would pose a problem.

185

Holt

Discusses
the term pharmacy benefit manager. Claims seeing potential problems in having
a pharmacy benefits manager involved. States there have been questions
nationally on the issue of pharmacy benefits managers. Explains concerns with
current methodologies they use, and whether or not they give people
contracting a fair deal.

280

Dolores
Hubert

Chair
of Health and Long-term Care Committee for Governor’s Commission on Senior
Services. Submits written testimony (EXHIBITF). Expresses three concerns to current
version of HB 3624 A:

States
Commission is aware of the budget crisis and cost needs to be controlled
within the Oregon Health Plan. Claims depending upon fully capitated health
plans, with so many that have fled, seem unrealistic. Comments creating an
administrative service organization will be problematic. Notes incentives for
fully capitated health plans to provide full services and supplies.

345

Hubert

Recommends
deleting section 10 from the bill and asking the Department of Human Services
to establish specific criteria to control costs for these categories and
allow the Department to create a centralized preauthorization system. Expresses
concern there is no exception for mandatory enrollment.

TAPE 28, B

020

Jacqueline
Zimmer

Oregon
Association of Area Agencies on Aging and Disabilities. Submits written
testimony (EXHIBIT G). Expresses
appreciation for the work the committee has put into the issue.. Explains ASO
responsibility for durable medical equipment and exemptions.

050

Zimmer

Claims
more money would be saved with regular training. Explains due to turnovers in
agencies, people need to be trained more effectively.

075

Elizabeth
Byers

Oregon
Health Action Campaign. Speaks briefly in support of the Oregon Health Action
Campaigns coming up with an amendment to address the issues discussed yesterday.
Discusses issues with amendments:

Ensure plans will cover people in the designated
areas.

Address medically fragile adults and children.

Include some of the good patient protections legislators
passed in the last two sessions.

Points
out people’s access to managed care. Believes it works for healthy people and
for those who have conditions that the managed care plan has providers for. Comments
she hopes there will be room in the bill allowing for those to maintain relationships
with their current providers.

115

Co-Chair
Winters

Closes
the public hearing on HB 3624 A. Adjourns the meeting at 5:00 p.m.

The following prepared testimony is
submitted for the record without public testimony for HB 3624 A: